LHL Hospital Gardermoen, Jessheim, Norway,
Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway,
Respiration. 2020;99(4):289-297. doi: 10.1159/000506295. Epub 2020 Mar 4.
There is limited evidence regarding the impact of multidisciplinary pulmonary rehabilitation (PR) on exercise capacity and fatigue in patients with pulmonary sarcoidosis. The aim of this study was to evaluate the impact on exercise capacity and fatigue following PR, and to examine whether baseline fatigue was related to change in peak oxygen uptake (ΔV̇O2peak).
Forty-one patients with pulmonary sarcoidosis attending a 4-week inpatient PR program were recruited to this pre-post study. Both maximal exercise capacity, defined as V̇O2peak and measured with a cardiopulmonary exercise test, and fatigue, assessed with the Fatigue Assessment Scale (score 10-50 points), were measured before and after PR.
There was a statistically significant improvement in V̇O2peak (1.2 ± 2.3 mL/kg/min, p = 0.002), and fatigue decreased significantly (-1.7 ± 3.9 points, p = 0.009) following PR. Unadjusted linear regression analyses demonstrated that age (B = -0.076, p = 0.017) and baseline fatigue (B = 0.196, p = 0.001) were predictors for change in V̇O2peak, while in adjusted analyses (age, sex, baseline V̇O2peak, baseline fatigue, and diffusion capacity of the lung for carbon monoxide), only baseline fatigue predicted change in V̇O2peak following PR (B = 0.165, p = 0.026).
A 4-week multidisciplinary PR program improves maximal exercise capacity and reduces fatigue in patients with pulmonary sarcoidosis. Baseline fatigue only partly predicted change in V̇O2peak following PR.
关于多学科肺康复（PR）对肺结节病患者运动能力和疲劳的影响，证据有限。本研究旨在评估 PR 后运动能力和疲劳的变化，并探讨基线疲劳与峰值摄氧量变化（ΔV̇O2peak）之间的关系。
本研究为前瞻性研究，共招募了 41 例参加 4 周住院 PR 计划的肺结节病患者。采用心肺运动试验测量最大运动能力（V̇O2peak），用疲劳评估量表（10-50 分）评估疲劳，分别在 PR 前后进行测量。
PR 后 V̇O2peak （1.2±2.3mL/kg/min，p=0.002）和疲劳（-1.7±3.9 分，p=0.009）均有显著改善。未调整的线性回归分析表明，年龄（B=-0.076，p=0.017）和基线疲劳（B=0.196，p=0.001）是 V̇O2peak 变化的预测因素，而在调整分析（年龄、性别、基线 V̇O2peak、基线疲劳和一氧化碳弥散量）中，只有基线疲劳预测 PR 后 V̇O2peak 的变化（B=0.165，p=0.026）。
为期 4 周的多学科 PR 方案可改善肺结节病患者的最大运动能力和疲劳。基线疲劳仅部分预测 PR 后 V̇O2peak 的变化。
